Related Experiment Video
Updated: Sep 2, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
[Biomarkers and neuromonitoring for prognosis of development after perinatal brain damage]
Ursula Felderhoff-Müser1, Britta Hüning1
1Klinik für Kinderheilkunde I, Neonatologie, Päd. Intensivmedizin, Neuropädiatrie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45157 Essen, Deutschland.
Insights
Predicting long-term neurodevelopment in infants with perinatal brain injury is challenging. This review examines current diagnostic tools and explores new biomarkers and technologies for accurate early prognosis and intervention.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Neonatology
Context:
- The developing brain is highly vulnerable during the perinatal period.
- Perinatal conditions like extreme prematurity and asphyxia can cause lifelong impairments.
- Early prediction of neurodevelopmental outcomes for at-risk infants remains a significant challenge.
Purpose:
- To review current diagnostic tools for early identification of brain lesions and functional disturbances in neonates.
- To explore novel biomarker patterns (omics, epigenetics) and emerging technologies for improved outcome prediction.
- To discuss the combination of diagnostic methods for enhanced prognostic accuracy.
Summary:
- Current methods include cerebral ultrasound, MRI, aEEG, NIRS, GMA, and clinical assessments (e.g., HNNE/HINE), requiring significant resources.
- Research is actively pursuing innovative biomarkers and (epi)genetic markers for more precise diagnosis.
- Accurate early prognosis is crucial for guiding interventions, leveraging the brain's high plasticity in early life.
Impact:
- Improved diagnostic accuracy for perinatal brain injury.
- Facilitation of timely and targeted early interventions for at-risk infants.
- Enhanced guidance for families and optimized follow-up care, potentially mitigating long-term disabilities.
Abstract:
In the perinatal period the developing brain is extremely vulnerable for a variety of insults. Perinatal conditions, such as extreme prematurity, perinatal asphyxia, and their complications can lead to lifelong sensorimotor, cognitive and behavioral impairment. Prediction of long-term neurodevelopment of preterm and ill term infants at risk for brain injury at an early stage remains a big challenge. Identification of brain lesions and disturbed function is essential for an accurate diagnosis. Currently, the prediction of the outcome is based on a variety of diagnostic tools and clinical assessment of developmental milestones. Several methods for early diagnosis and neuromonitoring of brain injury are available, such as cerebral ultrasound, magnetic resonance imaging (MRI) at term-equivalent age as well as neuromonitoring tools, such as amplitude-integrated electroencephalography (aEEG) and/or conventional EEG and near-infrared spectroscopy (NIRS), general movements assessment (GMA) and clinical assessment by, e.g., the Hammersmith neonatal/infant neurological examination (HNNE/HINE), all of which require substantial personnel and also technical resources. As better biomarkers are urgently needed scientific investigations currently focus on identification of innovative biomarker patterns (omics) and (epi)genetic markers. Furthermore, the individual child's development is determined not only by clinical risk factors, such as associated diseases but also by the socioeconomic environment. Estimation of the most accurate and early prognosis is cost-intensive, but crucial to adequately guide patients and counsel families. The initiation of early interventions is important as the plasticity of the developing brain is highest around birth and in the first few months of life. This review focuses on the characterization of the abovementioned diagnostic tools and the possibilities for combination for outcome prognosis. In addition, an outlook is given on how new technologies can facilitate the prediction of development and follow-up care of these children following perinatal brain injury.
